Endometrial cancer resection diagnosis

Endometrial cancer is one of the common malignant tumors of the female reproductive tract. The postoperative diagnosis of endometrial cancer is based on segmental curettage and pathological examination results. During segmental curettage, attention should be paid to the differences between endometrial adenocarcinoma infiltration, adenocarcinoma falling into the cervical canal, and cervical adenocarcinoma. Preoperative clinical staging is performed based on the results of pathological examination and in conjunction with other auxiliary examinations.

1. Clinical staging The International Federation of Gynecology and Obstetrics (FIGO, 1971) stipulates that before October 1989, endometrial cancer should be clinically staged according to the 1971 regulations. For those who cannot undergo surgery and need radiotherapy alone, the 1971 clinical staging is still used. Clinical staging of endometrial cancer Stage I cancer is confined to the uterine body Ia uterine cavity length ≤ 8cm Ib uterine cavity length > 8cm Stage II cancer involves the cervix Stage III cancer spreads outside the uterine body, into the pelvic cavity (vagina, para-uterine tissues may be involved, but not the bladder or rectum) Stage IV cancer involves the bladder or rectum, or there is dissemination outside the pelvic cavity. Note: According to the histological pathology, adenocarcinoma grading: G1 (well-differentiated adenocarcinoma), G2 (moderately differentiated adenocarcinoma, adenocarcinoma with some solid areas), G3 (most or all of it is undifferentiated cancer)

2. Surgical-pathological staging FIGO recommended the use of surgical-pathological staging for endometrial cancer in October 1988 (which was fully applied in clinical practice after 1989). A few notes on staging:

1. As endometrial cancer is now staged surgically, the previously used method of segmented curettage to distinguish between stage I and stage II is no longer used.

2. For a small number of patients, radiotherapy is the first choice and the clinical staging adopted by FIGO in 1971 is still used, but it should be indicated. Stage Tumor Range Stage Ia (G1,2,3) Cancer is limited to the endometrium Ib (G1,2,3) Cancer invasion depth <1/2 myometrium Ic (G1,2,3) Cancer invasion depth >1/2 myometrium Stage IIa (G1,2,3) Endocervical gland involvement IIb (G1,2,3) Cervical stroma involvement Stage IIIa (G1,2,3) Cancer involves the serosa and/or adnexa and/or abdominal cavity. Positive cytology IIIb (G1,2,3) Vaginal metastasis IIIc (G1,2,3) Pelvic lymph node and/or abdominal aortic lymph node metastasis Stage IVa (G1,2,3) Cancer invades the bladder or rectal mucosa IVb (G1,2,3) Distant metastasis, including intra-abdominal and/or inguinal lymph node metastasis.